Universal Care Model

Combining excellence in care management with state-of-the-art business intelligence.

Integrated Care

Universal Care believes in doing things the right way. No matter what the circumstances, we will always endeavour to provide:

• The Right Treatment
• By the Right Person
• In the Right Place
• At the Right Time
• For the Right Price

Through our comprehensive and expert approach, Universal Care offers an integrated care management service to medical scheme clients under one umbrella. The Universal Care offering enables medical schemes to contract cost-effectively with a single entity which provides the full range of managed care services.

Our integrated approach enables the sharing of information between the various care management functions and our administration division, which streamlines clinical funding decisions, and improves the responsiveness and quality of our service. This way, savings to the scheme are maximised and can be passed onto members in the form of lower contributions.

Clinical Committee

Universal Care has a full-time Clinical Committee comprising a team of healthcare professionals and experts who review clinical and funding decisions, and develop clinical guidelines which conform to the latest international best practice and scientific evidence. The Clinical Committee comprises a team of doctors, nurses and pharmacists, with input from independent academics, who have an in-depth understanding of clinical medicine as well as factors governing both the funding and provision of healthcare services.

The Clinical Committee also monitors ethical and professional codes of conduct of providers, and ensures that strong clinical governance and quality assurance in the provision of care and funding decisions are maintained.

Business Intelligence

A dedicated business intelligence unit, utilising the latest technology, ensures that our risk managers have access to detailed information and decision support systems through our Universal Care data warehouse.

Universal’s database of healthcare risk management and administrative information spans more than a decade, and enables detailed analytical and data management procedures for the purposes of utilisation management, benchmarking, case mix adjustment and risk-adjusted mathematical modelling. Regular feedback and reports are provided to decision makers and clients.

Flexibility

Universal Care provides a highly personalised service to each of our clients. The application of our risk management models is customised to the requirements of each individual medical scheme client.

Universal Care has the ability to apply individual scheme-specific and even option-specific rules and reimbursement models.

Personalised Care

Universal Care is committed to providing personalized, patient specific managed care where each patient's unique medical situation is taken into accounts